Petitioner Pro Se IN THE FAMILY COURT OF THE SECOND CIRCUIT STATE OF HAWAII 2FP-09 (Rev 11/11) CommonLook256 ) ) ) ) ) ) )) ) ) Petitioner(s), vs. Respondent(s). FC-P No. AFFIDAVIT OF PETITIONER ) ) AFFIDAVIT OF PETITIONER002 ) )) STATE OF HAWAII COUNTY OF MAUI SS. I, , Petitioner in the above-entitled action depose and state that: 1. The child subject to this action is: Name:Sex:Date of Birth: Place of Birth: Period of Conception: Place of Conception: 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com 2. I am not the father of , born, as I did not have access to , the Natural Mother, during the child222s conception period. AFFIANT FURTHER SAYETH NAUGHT. DATED: , Hawaii Petitioner Pro Se ) )STATE OF HAWAII COUNTY OF MAUI SS. ) On this day of , 20 before me personally appeared , to me known to be the person described in and who executed the foregoing instrument and acknowledged that he executed the same as his free act and deed. Notary Public, Second Judicial CircuitState of Hawaii My Commission Expires: In accordance with the Americans with Disabilities Act and other applicable state and federal laws, if you require a reasonable accommodation for a disability, please contact the ADA Coordinator at the Family Court Administration Office at PHONE NO. 244-2700, FAX 244-2704 OR TTY 244-2889 at least ten (10) working days prior to your hearing or appointment date. For all Civil related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Room 141, Wailuku, HI 96793 2FP-09 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com